Successful In Vitro and In Vivo Treatment of Tinea Pedis with a Nitric Oxide-releasing Gel
Notice bibliographique
Résumé
Introduction: Tinea pedis (athlete’s foot) is among the most common superficial fungal infections worldwide, affecting up to 70% of individuals in their lifetime. Caused primarily by Trichophyton rubrum and Trichophyton interdigitale, it manifests as interdigital maceration, hyperkeratotic scaling, or vesiculobullous eruptions. Treatment is often complicated by increasing resistance to standard antifungal therapies. Nitric oxide (NO), a broad-spectrum antimicrobial with multiple cellular targets, represents a promising alternative. Previous work with a nitric oxide releasing solution (NORS) demonstrated fungicidal efficacy in keratin-rich environments and clinical utility in foot bath studies, but real-world application was limited by treatment logistics. This study evaluates a novel nitric oxide releasing gel (NORS-gel) designed for practical patient use. Aim: To investigate the antifungal efficacy, dermal penetration, mechanism of action, and preliminary clinical performance of NORS-gel in refractory tinea pedis. Methods: Antifungal activity was assessed against T. rubrum and T. mentagrophytes using (1) time-kill assays, (2) zone of inhibition tests across synthetic dermal membranes, and (3) scanning electron microscopy (SEM) for morphological effects. A single-patient case study evaluated safety, tolerability, and clinical efficacy. Treatment involved twice-daily topical application for one week, followed by once-daily use for four weeks. Symptom severity was measured using the Athlete’s Foot Severity Score (AFSS). Results: NORS-gel demonstrated rapid fungicidal activity, achieving complete kill of T. rubrum within one minute and T. mentagrophytes within an average of 2.8 minutes, while placebo had no effect. In dermal membrane assays, NORS-gel penetrated the synthetic barrier and maintained fungicidal efficacy, producing zones of inhibition 57% larger than those with Tolcylen and significantly outperforming tolnaftate, which failed to penetrate. SEM revealed extensive structural disruption, impaired hyphal formation, and fungal cell wall perforations, confirming a fungicidal—not fungistatic—mechanism. In the clinical case, a 37-year-old male with refractory interdigital tinea pedis unresponsive to terbinafine and clotrimazole achieved complete symptomatic resolution after five weeks. AFSS decreased from 24 at baseline to 0 at week 5. Adverse effects were limited to mild, transient yellow skin discoloration and dryness, managed with moisturizer. Conclusions: NORS-gel exhibited rapid, potent fungicidal activity in vitro, effective dermal penetration with sustained efficacy, and striking morphological disruption of fungal structures. Clinically, a refractory case of tinea pedis resolved completely within five weeks of treatment. Nitric oxide’s multifaceted antimicrobial mechanism may reduce risk of resistance development and confer added benefits in wound healing. While these findings are preliminary, they highlight the therapeutic potential of NORS-gel as a novel topical antifungal agent. Larger randomized controlled trials are warranted to confirm efficacy, optimize dosing regimens, and establish long-term safety. Sponsored: SaNOtize Research and Development Corporation
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».